Objective. To evaluate efficacy of nutrition support of severe traumatic brain injury (TBI).
Materials and methods. 78 severe TBI patients were examined. They were 71 (91 %) men and 7 (9 %) women in age of 51,0 [35,0; 59,0] years. The cognition state was 8,0 [6,0; 12,8], which was quantified by Coma Glasgow Scale (GCS). The assessment of nutritional status at admission with NRS — 2002 was performed. All patients were separated into two groups in order of protein value in nutrition support: the control group was included 24 patients with protein targets equivalent of 1,2 g of protein per kg of actual body weight per day; the main group (n=54) was got ³1,2 g of protein per kg of actual body weight per day. Descriptive data are reported as medians and interquartile ranges (IQR) (Me [q25; q75]). Survival was analysed in categories as Kaplan — Meier plots. Cox regression analyses were performed for indexing the factors of lethal outcomes.
Results. The one patient (1,3 %) had deficiency of body weight, at the same time all patients (n=78) suffered from high risk of malnutrition (NRS — 2002 was e”3 points). Kaplan-Meier plots were reviled that when patients got more protein ( ³1,2 g of protein per kg of actual body weight per day), the risk of death would be fewer on 27 % than, if they got less protein (1,2 g of protein per kg of actual body weight per day) p=0,0101. Body weight index was the independent risk factors of death according Cox regression analyses. However, age and GCS hadn’t statistically significant influence on risk lethal outcome for 30-day ICU stay.
Conclusion. The usage of high protein nutrition support ( ³1,2 g/kg/day) would be able to lower on 27 % the risk of death of severe TBI patients in 30 days ICU period. More efficient nutrition support was combination of medical diet, enteral and parenteral nutrition.Ключевые слова:
Автор(ы): V. V. Hancharou, V. I. Sviatlitskaya, S. Y. Komlikov